The goal of this postdoctoral training program is to train excellent health services researchers who can address the well-documented critical gaps in child health services research and fundamentally improve the capacity of the U.S. health care system to meet the needs of children and families, including socioeconomically disadvantaged and minority populations. This focus on children is responsive to AHRQ's designation of children as a priority population. The program pursues continuous improvement in four key processes to achieve this goal: 1) recruitment and retention, including recruitment of trainees from underrepresented minority groups; 2) research training, including course work in core methodologies at the Harvard School of Public Health (HSPH) leading to an M.P.H., small-group interactive seminars, structured research guidance by experienced mentorship teams, access to a diverse faculty and health services research "basic scientists" versed in disciplines required for cutting-edge research, and preparation for presentations, publications, and grant submissions; 3) support for career transition, including successful competition for career development awards; and 4) replication and dissemination by leveraging AHRQ support to extend the program's impact, especially by building research capacity in other states through two BRIC collaborations. The experienced leadership team monitors progress towards meeting these goals through surveys of trainees, measures of research productivity and career success of trainees, and feedback from an advisory board. The leadership team has exceeded all of the goals established for the current award period, justifying a request for an increase from 8 to 10 positions per year, accommodating five new M.D. or Ph.D. fellows each year for a two-year duration of training. In 1998 the program expanded from a single site at Children's Hospital (CH) to a Harvard-wide program with two other institutions, MassGeneral Hospital for Children and the Department of Ambulatory Care and Prevention. This dramatically increased the strength and diversity of the program's mentors and faculty, and access to diverse research environments and important databases. In addition to forging this harmonious, synergistic collaboration, the leadership team strengthened links to faculty at Harvard Medical School (HMS) and other Harvard institutions, as well as to the two other AHRQ programs at Harvard. [unreadable] [unreadable]